SYPHILIS

Source: INDIANEXPRESS

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Context

• Improved testing efforts in Mumbai have led to the detection of over 6,000 syphilis cases between 2018-19 and 2022-23.
• The Mumbai AIDS Control Society (MDACS) attributes the increase in detected cases to expanded testing.

Details

Syphilis

• Syphilis is a sexually transmitted infection (STI) caused by the bacterium Treponema pallidum.
• It has been a significant public health concern for centuries due to its ability to cause severe health complications if left untreated.

Historical Background

• Syphilis was first recognized in Europe in the late 15th century.
• The disease has been known by various names, including the "Great Pox."
• The bacterium Treponema pallidumwas identified in the early 20th century, and the development of penicillin in the 1940s revolutionized its treatment.

Epidemiology

• Syphilis affects millions of people worldwide.
• The incidence and prevalence of the disease vary by region, with higher rates often observed in low- and middle-income countries.
• Recent years have seen a resurgence of syphilis in many high-income countries, particularly among men who have sex with men (MSM).

Transmission

• Syphilis is primarily transmitted through sexual contact, including vaginal, anal, and oral sex.
• It can also be transmitted from an infected mother to her baby during pregnancy or childbirth, leading to congenital syphilis.

Clinical Stages

Syphilis progresses through several stages if left untreated:

• Primary Syphilis: Characterized by the appearance of a painless sore (chancre) at the site of infection, usually on the genitals, anus, or mouth. The chancre heals within 3-6 weeks, even without treatment.
• Secondary Syphilis: Symptoms include skin rashes, mucous membrane lesions, fever, sore throat, swollen lymph nodes, and hair loss. These symptoms may resolve without treatment but can recur.
• Latent Syphilis: A period where the infection is not active, and symptoms are absent. Latent syphilis can last for years. It is divided into early latent (within one year of infection) and late latent (after one year).
• Tertiary Syphilis: Occurs in about 15-30% of untreated cases and can appear years or decades after the initial infection. It can cause severe damage to the heart, brain, nerves, eyes, bones, and other organs, leading to life-threatening complications.

Congenital Syphilis

• Congenital syphilis occurs when a pregnant woman with syphilis transmits the infection to her baby.
• It can result in miscarriage, stillbirth, or severe health problems for the newborn, including deformities, developmental delays, and organ damage.

Treatment

Penicillin is the most effective treatment for syphilis. The treatment regimen depends on the stage of the disease:

• Primary, secondary, and early latent syphilis: A single intramuscular injection of benzathine penicillin G.
• Late latent and tertiary syphilis: Three weekly intramuscular injections of benzathine penicillin G.

Sexually Transmitted Infections (STIs)

• Sexually transmitted infections (STIs) are infections primarily spread through sexual contact.
• They can be caused by bacteria, viruses, parasites, or fungi and affect millions of people globally.
• Effective prevention, diagnosis, and treatment are essential to control and reduce the spread of STIs.

Common Types of STIs

• Bacterial STIs:
  • Chlamydia: Caused by Chlamydia trachomatis, it is one of the most common STIs. Symptoms include genital discharge and pain during urination, but many cases are asymptomatic.
  • Gonorrhea: Caused by Neisseria gonorrhoeae, it can infect the genitals, rectum, and throat. Symptoms are similar to chlamydia and can lead to serious complications if untreated.
  • Syphilis: Caused by Treponema pallidum, it progresses through primary, secondary, latent, and tertiary stages, with potentially severe long-term health effects.
• Viral STIs:
  • Human Immunodeficiency Virus (HIV): A virus that attacks the immune system and can lead to AIDS if untreated. It is transmitted through sexual contact, blood, and from mother to child during childbirth or breastfeeding.
  • Human Papillomavirus (HPV): The most common STI, with many strains. Some strains cause genital warts, while others are associated with cancers, such as cervical cancer.
  • Herpes Simplex Virus (HSV): HSV-1 typically causes oral herpes, while HSV-2 causes genital herpes. Both can cause painful sores and blisters.
  • Hepatitis B and C: Viruses that affect the liver, transmitted through sexual contact, blood, and other bodily fluids. They can lead to chronic liver disease and liver cancer.
• Parasitic STIs:
  • Trichomoniasis: Caused by the protozoan Trichomonas vaginalis. Symptoms include itching, burning, and discharge, but many cases are asymptomatic.
• Fungal STIs:
  • Candidiasis: Also known as yeast infection, caused by Candida It can result in itching, discharge, and discomfort.

Sources:

INDIANEXPRESS

PRACTICE QUESTION Q: With reference to sexually transmitted infections (STIs), consider the following statements: Human papillomavirus (HPV) infection can lead to cervical cancer. Gonorrhea can be effectively treated with antibiotics. All STIs present symptoms that are easily noticeable. Which of the statements given above is/are correct? (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (d) 1, 2, and 3 Answer: (a)